Provider Demographics
NPI:1942952890
Name:EMPOWER & NOURISH
Entity Type:Organization
Organization Name:EMPOWER & NOURISH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN NUTRITIONIST
Authorized Official - Prefix:
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAEBIG
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:920-539-3454
Mailing Address - Street 1:2141 N OAKLEY AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-0375
Mailing Address - Country:US
Mailing Address - Phone:920-539-3454
Mailing Address - Fax:
Practice Address - Street 1:2141 N OAKLEY AVE APT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-0375
Practice Address - Country:US
Practice Address - Phone:920-539-3454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty